CMS releases July 2022 enrollment report: Medicaid/CHIP enrollment hits 90 million for first time in history

via the Centers for Medicare & Medicaid Services (CMS), by email:

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

Medicare

As of July 2022, 64,831,706 people are enrolled in Medicare. This is an increase of 149,601 since the last report. 

• 34,919,687 are enrolled in Original Medicare.

• 29,912,019 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.
• 50,343,344 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage.

• Over 12 million individuals are dually eligible for Medicare and Medicaid, so are counted in the enrollment figures for both programs.

Detailed enrollment data can be viewed here.

That's right: 46.1% of all Medicare enrollees are now enrolled in Medicare Advantage, the privately-administered version of the program. This trend has been growing every year for the past couple decades, for good or for bad.

As of July 2022, 89,960,717 people are enrolled in Medicaid and CHIP. This is an increase of 516,557 since the last report. 

• 82,845,954 are enrolled in Medicaid

• 7,114,763 are enrolled in CHIP

For more information on Medicaid/CHIP enrollment, including enrollment trends, visit here.

Last June, CMS confirmed that total Medicaid/CHIP enrollment had officially broken 80 million Americans...as of January 2021. However, this was six months out of date and, just as significantly, utilized the Medicaid/CHIP Enrollment Trends Snapshot report. The problem with this is that the Trends Snapshot reports leave out some Medicaid enrollees which are included in a different CMS report, the Medicaid Budget & Expenditure System (MBES):

• The MBES count includes individuals enrolled in limited benefit plans and the Performance Indicator count does not include such individuals.

• The MBES data represents the count of unduplicated individuals enrolled in the state’s Medicaid program at any time during each month in the quarterly reporting period, while the Performance Indicator data captures the count of individuals enrolled on the last day of the month.

• The MBES count only includes individuals whose coverage is funded through Medicaid (title XIX of the Social Security Act), while the published Performance Indicator also includes individuals funded through CHIP (title XXI of the SSA).

• MBES and Performance Indicator data may be derived from different state systems.

• Retroactive state adjustments to MBES or Performance Indicator data may be in progress.

• States have likely generated MBES data and Performance Indicator data from state systems on different dates.

Some of these actually cancel each other out; the first two favor the MBES counts while the third makes the Performance Indicator total higher. The last three bullets don't really lean one way or another.

However, there's another important difference: The MBES reports include around 1.5 million Medicaid enrollees in the U.S. territories (American Samoa, Guam, N. Mariana Islands, Puerto Rico & US Virgin Islands) which aren't included in the Performance Indicator reports for some reason.

When you add those ~1.5 million, plus the fact that the MBES report is over a year out of date and the likely further increase of a few hundred thousand more in the Performance Indicator report since July, total Medicaid/CHIP enrollment is almost certainly closer to ~92 million as of today.